Spasticity
Study register · detail Kohortenstudie · Spasticity · 2016

THC:CBD Observational Study Data: Evolution of Resistant MS Spasticity and Associated Symptoms.

Clear benefit GRADE Low 3 citations
Samplen = 300 Pat.
Duration3 months observation
EndpointNRS
Blindingn.a.
DesignKohortenstudie
Cannabinoidkombination
THC:CBD1:1
Routeoromukosal
Key finding

THC:CBD spray led to meaningful improvements in spasticity as measured by patient rating scale and modified Ashworth scale at lower doses and with fewer adverse events than in RCT.

Summary

Prospective observational study MOVE 2-Italy, n>300 MS patients with treatment-resistant spasticity, THC:CBD spray as add-on to baclofen over 3 months; significant improvement on 0-10 NRS and modified Ashworth scale at mean daily doses ~1/3 lower than in RCTs; discontinuation rate low, adverse event rate ~1/3 of RCT rate.

P
PopulationAdults with treatment-resistant MS spasticity, n>300 (interim analysis), treated in >30 Italian MS centres
I
InterventionTHC:CBD oromucosal spray (nabiximols) as add-on to existing therapy (predominantly oral baclofen), real-world clinical practice
O
OutcomeSignificant improvements on the patient-based NRS (0-10) and the physician-assessed modified Ashworth scale after 3 months; mean daily dose approx. one third lower than in the RCT; discontinuation rate and adverse events approx. one third of RCT level
Confidence in the evidence
Low

The second of four GRADE levels, the effect estimate is of limited reliability.

Quality profile
Sample size
Blinding
Effect size Clear benefit
Citations / year
Authors
Trojano M
DOI 10.1159/000444235
Design: Kohortenstudie
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Abstract
Background: The prospective observational MObility ImproVEment (MOVE) 2 study is collecting real-life clinical outcomes data on patients with treatment-resistant multiple sclerosis (MS) spasticity treated with THC:CBD oromucosal spray in routine clinical practice. The MOVE 2 study has been ongoing in Italy, involving more than 30 MS centres across the country, since 2013. Methods: Web-based real-time data collection techniques are combined with traditional patients' diaries to capture a wide spectrum of outcomes associated with this innovative cannabis-based medication. After surpassing the recruitment threshold of 300 patients, an interim analysis was performed to determine whether the data collected to date align with those from MOVE 2-Germany and the largest phase III randomized controlled trial (RCT) of THC:CBD oromucosal spray. Results: In the Italian cohort, THC:CBD oromucosal spray was added mainly to oral baclofen. Similar to MOVE 2-Germany, during 3 months' observation, treatment discontinuations were limited and patients recorded meaningful improvements on the patient-based 0-10 numerical rating scale and physician-rated modified Ashworth scale at mean daily doses that were about one-third lower than those used in the RCT. Also, similar to MOVE 2-Germany, the proportion of patients reporting adverse events was about one-third of the rate recorded in the Rct. Conclusions: While MOVE 2-Italy continues, this interim analysis has enabled us to better define the place in therapy of THC:CBD oromucosal spray within the context of daily management of our patients with MS spasticity.

The impediment to action advances action. — Marcus Aurelius